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Drug Interactions between Bethkis and kanamycin

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

tobramycin kanamycin

Applies to: Bethkis (tobramycin) and kanamycin

GENERALLY AVOID: Use of more than one aminoglycoside concurrently or sequentially may increase the risk of nephrotoxicity and ototoxicity. The risk is greatest in patients with impaired renal function, those receiving high doses for prolonged periods of time, elderly patients, and dehydrated patients. Ototoxicity may occur without renal toxicity. Oral neomycin undergoes systemic absorption and has also been associated with nephrotoxicity and ototoxicity.

MANAGEMENT: The use of more than one aminoglycoside should be avoided. Patients receiving aminoglycosides should be closely monitored for development of toxicity, including renal function tests and serial, vestibular, and audiometric tests. Ototoxicity may be permanent and may not be apparent until long after therapy has been discontinued. The onset of auditory toxicity may be asymptomatic or may manifest with early symptoms such as feelings of fullness in the ear, high tone hearing loss, or tinnitus. Signs of vestibulotoxicity include ataxia, tinnitus, and vertigo.

References (13)
  1. Lawson DH, Tilstone WJ, Gray JM, Srivastava PK (1982) "Effect of furosemide on the pharmacokinetics of gentamicin in patients." J Clin Pharmacol, 22, p. 254-8
  2. Kaka JS, Lyman C, Kilarski DJ (1984) "Tobramycin-furosemide interaction." Drug Intell Clin Pharm, 18, p. 235-8
  3. Halstenson CE, Hirata CA, Heim-Duthoy KL, Abraham PA, Matzke GR (1990) "Effect of concomitant administration of piperacillin on the dispositions of netilmicin and tobramycin in patients with end-stage renal disease." Antimicrob Agents Chemother, 34, p. 128-33
  4. Weibert R, Keane W, Shapiro F (1976) "Carbenicillin inactivation of aminoglycosides in patients with severe renal failure." Trans Am Soc Artif Intern Organs, 22, p. 439-43
  5. Dupuis JY, Martin R, Tetrault JP (1989) "Atracurium and vecuronium interaction with gentamicin and tobramycin." Can J Anaesth, 36, p. 407-11
  6. Mathog RH, Klein WJ (1969) "Ototoxicity of ethacrynic acid and aminoglycoside antibiotics in uremia." N Engl J Med, 280, p. 1223-4
  7. Johnson AH, Hamilton CH (1970) "Kanamycin ototoxicity: possible potentiation by other drugs." South Med J, 63, p. 511-3
  8. (2007) "Product Information. Garamycin (gentamicin)." Schering-Plough Corporation
  9. (2001) "Product Information. Nebcin (tobramycin)." Lilly, Eli and Company
  10. (2001) "Product Information. Mycifradin (neomycin)." Emerson Laboratories
  11. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  12. Cerner Multum, Inc. "Australian Product Information."
  13. (2018) "Product Information. Arikayce (amikacin liposome)." Insmed Incorporated

Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Aminoglycosides

Therapeutic duplication

The recommended maximum number of medicines in the 'aminoglycosides' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'aminoglycosides' category:

  • Bethkis (tobramycin)
  • kanamycin

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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